The Factors Of Virologic Breakthrough In Entecavir Treatment Chronic Hepatitis B Patients

Objective:To investigate the factors of virologic breakthrough in entecavir treatmentchronic hepatitis B (CHB) patients.Methods:To collected the medical records of263patients with CHB infected who used entecavir (ETV), surveied with retrospective andanalysed the patients with biochemical,virological,medication history, compliance index;analysed whether affect virologic breakthrough occurred, and analysed the association ofrelevant index and ETV virological breakthrough.Results:After24months,in the263patients,24cases occurred virologic breakthrough, and the rate was9.13%.Viralbreakthrough rate in HBeAg positive and negative were11.18%,5.38%, the differencehad not statistically significant (P＝0.118);Viral breakthrough rates in LAM usage and nousage of LAM were14.95%,5.13%, the difference was statistically significant (P＝0.007);Viral breakthrough rates in ETV1.0mg and0.5mg were7.41%,9.32%, the difference wasnot statistically significant (P＝1.000);Viral breakthrough rates in cirrhosis and withoutcirrhosis of the liver in patients were15.63%,7.04%, the difference was statisticallysignificant (P＝0.038); Viral breakthrough rates in poor compliance and adherence inpatients with were29.41%,6.11%, the difference was statistically significant (P=0.000);Viral breakthrough in ALT low,medium and high level group incidence were10.24%,6.48%,14.29%, the difference between the three levels of group had notstatistically significant (P＞0.05);Viral breakthrough in low,medium,high-level group ofHBV-DNA occurred5.06%,5.56%,18.42%, HBV-DNA in initial treatment of low leveland medium level had not statistically significant (P＞0.05), low, high level andmedium,high level had statistically significant (P＜0.05). After6months of treatment, thehigher rate of HBV-DNA negative,the lower incidence of viral breakthrough. Aftert treate12months the rate of virologic breakthrough in LAM usage was2.80%, and after24months the rate was14.95%, and the average time occurred virologic breakthrough was (19.88±4.76) months.At the treatment of12month viral breakthrough in untreated patientincidenced was0.64%, and24months was5.13%.Conclusion:LAM usage, high level ofHBV-DNA, cirrhosis, poor compliance were risk factors in entecavir occur virologicbreakthrou-gh;After6months of treatment, the higher rate of HBV-DNA negative,thelower incidence of viral breakthrough;The rate of virologic breakthrough in LAM usagewith a high incidence compared with entecavir untreated.